Provider Demographics
NPI:1043657190
Name:MCCAHILL, KELLEY ANN (CADC II, LPC)
Entity Type:Individual
Prefix:
First Name:KELLEY
Middle Name:ANN
Last Name:MCCAHILL
Suffix:
Gender:F
Credentials:CADC II, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 FANT DR
Mailing Address - Street 2:
Mailing Address - City:FT OGLETHORPE
Mailing Address - State:GA
Mailing Address - Zip Code:30742-3307
Mailing Address - Country:US
Mailing Address - Phone:706-806-1270
Mailing Address - Fax:706-806-1186
Practice Address - Street 1:1875 FANT DR
Practice Address - Street 2:
Practice Address - City:FT OGLETHORPE
Practice Address - State:GA
Practice Address - Zip Code:30742-3307
Practice Address - Country:US
Practice Address - Phone:706-806-1270
Practice Address - Fax:706-806-1186
Is Sole Proprietor?:No
Enumeration Date:2013-05-30
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA583101YA0400X
GALPC010647101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)